Is your doctor currently prescribing medication for your blood pressure or heart condition?:
Is your doctor currently prescribing medication for your blood pressure or heart condition? field is required

Do you have a bone or joint problem (for example, back, knee, or hip) that could be made worse by a change in your physical activity?:
Do you have a bone or joint problem (for example, back, knee, or hip) that could be made worse by a change in your physical activity? field is required

Do you lose you balance because of dizziness or do you ever lose consciousness?:
Do you lose you balance because of dizziness or do you ever lose consciousness? field is required

I confirm that
I am voluntarily engaging in an acceptable level of exercise, and my participation involves a risk of injury.:
I confirm that
I am voluntarily engaging in an acceptable level of exercise, and my participation involves a risk of injury. field is required

In the past month, have you had a chest pain when you were not doing physical activity?:
In the past month, have you had a chest pain when you were not doing physical activity? field is required

I have read, understood and accurately completed this questionnaire.:
I have read, understood and accurately completed this questionnaire. field is required

Do you feel pain in your chest when you do physical activity?:
Do you feel pain in your chest when you do physical activity? field is required

Do you know of any other reason why you should not do physical activity?:
Do you know of any other reason why you should not do physical activity? field is required

Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor?:
Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor? field is required